Skip to main content
SpringerLink
Log in

Ten to fifteen-year clinical and radiographic follow-up with a third-generation cementless stem in a young patient population

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

Outcome data beyond 11 years of follow-up is not available for the third-generation Zweymüller femoral stem in combination with a polyethylene bearing. We report ten to 15-year results with this total hip arthroplasty (THA) combination in a young population.

Methods

A retrospective, observational, non-randomised, single-centre, clinical observational study was conducted in which 311 primary THAs were performed in 276 patients between 1996 and 2000 using a third-generation Zweymüller stem. The mean age of the patients at operation was 47.4 years (range 18–77 years).

Results

Stem survival for any reason was 93.5 % after ten years and 89.6 % after 13 years, and the probability of aseptic stem loosening was 98.7 % at both ten and 13 years. The occurrence of femoral radiolucent lines was low, at just 17.2 %. Minor femoral osteolysis was identified in 30 % of patients and was attributed to polyethylene liner wear. Clinical and patient satisfaction outcomes were in line with previous investigations, and the rate of adverse events was low.

Conclusions

The third-generation Zweymüller stem shows good radiographic and clinical results and good longevity, including in the younger osteoarthritic patient. The use of low-wear bearings may further reduce the rate of osteolysis and wear-related revision in young and active patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Eskelinen A, Remes V, Helenius I, Pulkkinen P, Nevalainen J, Paavolainen P (2005) Total hip arthroplasty for primary osteoarthrosis in younger patients in the Finnish arthroplasty register. 4,661 primary replacements followed for 0–22 years. Acta Orthop 76(1):28–41

    Article  PubMed  Google Scholar 

  2. Malchau H, Herberts P, Eisler T, Garellick G, Soderman P (2002) The Swedish total hip replacement register. J Bone Joint Surg Am 84-A(Suppl 2):2–20

    PubMed  Google Scholar 

  3. Havelin LI, Engesaeter LB, Espehaug B, Furnes O, Lie SA, Vollset SE (2000) The Norwegian arthroplasty register: 11 years and 73,000 arthroplasties. Acta Orthop Scand 71(4):337–353

    Article  CAS  PubMed  Google Scholar 

  4. Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51(4):737–755

    CAS  PubMed  Google Scholar 

  5. Klassbo M, Larsson E, Mannevik E (2003) Hip disability and osteoarthritis outcome score. An extension of the Western Ontario and McMaster Universities Osteoarthritis Index. Scand J Rheumatol 32(1):46–51

    Article  PubMed  Google Scholar 

  6. Nilsdotter AK, Lohmander LS, Klassbo M, Roos EM (2003) Hip disability and osteoarthritis outcome score (HOOS)—validity and responsiveness in total hip replacement. BMC Musculoskelet Disord 4:10

    Article  PubMed Central  PubMed  Google Scholar 

  7. Gruen T, McNeice G, Amstutz H (1979) “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 141:17–27

    PubMed  Google Scholar 

  8. Zweymüller K (2007) Good results with an uncoated grit-blasted tapered straight stem at ten years. Interact Surg 2(3):197–2005

    Article  Google Scholar 

  9. Brooker A, Bowerman J, Robinson R, Riley LJ (1973) Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am 55(8):1629–1632

    CAS  PubMed  Google Scholar 

  10. Engh CA, Massin P, Suthers KE (1990) Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res 257:107–128

    PubMed  Google Scholar 

  11. Kaplan E, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481

    Article  Google Scholar 

  12. Korovessis P, Repantis T, Zafiropoulos A (2011) High medium-term survivorship and durability of Zweymuller-Plus total hip arthroplasty. Arch Orthop Trauma Surg 131(5):603–611

    Article  PubMed  Google Scholar 

  13. Milosev I, Kovac S, Trebse R, Levasic V, Pisot V (2012) Comparison of ten-year survivorship of hip prostheses with use of conventional polyethylene, metal-on-metal, or ceramic-on-ceramic bearings. J Bone Joint Surg Am 94(19):1756–1763

    Article  PubMed  Google Scholar 

  14. Topolovec M, Milosev I (2014) A comparative study of four bearing couples of the same acetabular and femoral component: a mean follow-up of 11.5 years. J Arthroplasty 29(1):176–180

    Article  PubMed  Google Scholar 

  15. Wick M, Lester DK (2004) Radiological changes in second- and third-generation Zweymuller stems. J Bone Joint Surg (Br) 86(8):1108–1114

    Article  CAS  Google Scholar 

  16. Grubl A, Chiari C, Giurea A et al (2006) Cementless total hip arthroplasty with the rectangular titanium Zweymuller stem. A concise follow-up, at a minimum of fifteen years, of a previous report. J Bone Joint Surg Am 88(10):2210–2215

    Article  PubMed  Google Scholar 

  17. Pospischill M, Knahr K (2005) Cementless total hip arthroplasty using a threaded cup and a rectangular tapered stem. Follow-up for ten to 17 years. J Bone Joint Surg (Br) 87(9):1210–1215

    Article  CAS  Google Scholar 

  18. Eskelinen A, Remes V, Helenius I, Pulkkinen P, Nevalainen J, Paavolainen P (2006) Uncemented total hip arthroplasty for primary osteoarthritis in young patients: a mid-to long-term follow-up study from the Finnish Arthroplasty Register. Acta Orthop 77(1):57–70

    Article  PubMed  Google Scholar 

  19. Kim YH, Kim JS, Park JW, Joo JH (2011) Comparison of total hip replacement with and without cement in patients younger than 50 years of age: the results at 18 years. J Bone Joint Surg (Br) 93(4):449–455

    Article  CAS  Google Scholar 

  20. Zweymuller KA, Steindl M, Schwarzinger U (2007) Good stability and minimal osteolysis with a biconical threaded cup at 10 years. Clin Orthop Relat Res 463:128–137

    PubMed  Google Scholar 

  21. Tozun IR, Ozden VE, Dikmen G, Beksac B (2014) Mid-term result of ceramic bearings in total hip arthroplasty. Int Orthop 38(10):2027–2031

    Article  PubMed  Google Scholar 

  22. Salemyr M, Muren O, Ahl T, Boden H, Chammout G, Stark A, Skoldenberg O (2015) Vitamin-E diffused highly cross-linked polyethylene liner compared to standard liners in total hip arthroplasty. A randomized, controlled trial. Int Orthop

  23. Zweymuller K, Schwarzinger U, Steindl M (2006) Radiolucent lines and osteolysis along tapered straight cementless titanium hip stems: a comparison of 6-year and 10-year follow-up results in 95 patients. Acta Orthop 77(6):871–876

    Article  PubMed  Google Scholar 

  24. Archibeck M, Berger R, Jacobs J (2001) Second-generation cementless total hip arthroplasty. Eight to eleven-year results. J Bone Joint Surg 83-A:1666–1673

    CAS  PubMed  Google Scholar 

  25. Pieringer H, Auersperg V, Griessler W, Bohler N (2003) Long-term results with the cementless Alloclassic brand hip arthroplasty system. J Arthroplasty 18(3):321–328

    Article  PubMed  Google Scholar 

  26. Koster G, Leib S, Willert H (1998) Noncemented hip replacement using a conical screw-in cup and a straight press-fit stem. A six to eight-year clinical and radiological follow-up study. Hip Int 8:208–218

    Google Scholar 

  27. Lintner F, Zweymuller K, Brand G (1986) Tissue reactions to titanium endoprostheses. Autopsy studies in four cases. J Arthroplasty 1(3):183–195

    Article  CAS  PubMed  Google Scholar 

  28. Zweymuller K, Samek V (1990) In: Zweymuller K (ed) Radiologische Grundphanomene des Titanium-Geradschaftes. Verlag Hans Huber, Bern, p 23

    Google Scholar 

  29. Biemond JE, Venkatesan S, van Hellemondt GG (2015) Survivorship of the cementless Spotorno femoral component in patients under 50 years of age at a mean follow-up of 18.4 years. Bone Joint J 97-B(2):160–163

    Article  CAS  PubMed  Google Scholar 

  30. McLaughlin JR, Lee KR (2014) Uncemented total hip arthroplasty using a tapered femoral component in obese patients: an 18–27 year follow-up study. J Arthroplasty 29(7):1365–1368

    Article  PubMed  Google Scholar 

  31. Innmann MM, Gotterbarm T, Kretzer JP et al (2014) Minimum ten-year results of a 28-mm metal-on-metal bearing in cementless total hip arthroplasty in patients fifty years of age and younger. Int Orthop 38(5):929–934

    Article  PubMed Central  PubMed  Google Scholar 

  32. Pieringer H, Labek G, Auersperg V, Bohler N (2003) Cementless total hip arthroplasty in patients older than 80 years of age. J Bone Joint Surg (Br) 85(5):641–645

    CAS  Google Scholar 

  33. Chen C, Xenos J, McAuley J, Young A, Engh CS (2006) Second-generation porous-coated cementless total hip arthroplasties have high survival. Clin Orthop Relat Res 451:121–127

    Article  PubMed  Google Scholar 

  34. Garcia-Cimbrelo E, Cruz-Pardos A, Madero R, Ortega-Andreu M (2003) Total hip arthroplasty with use of the cementless Zweymuller Alloclassic system. A ten to thirteen-year follow-up study. J Bone Joint Surg Am 85-A(2):296–303

    PubMed  Google Scholar 

  35. Grubl A, Chiari C, Gruber M, Kaider A, Gottsauner-Wolf F (2002) Cementless total hip arthroplasty with a tapered, rectangular titanium stem and a threaded cup: a minimum ten-year follow-up. J Bone Joint Surg Am 84-A(3):425–431

    PubMed  Google Scholar 

  36. Sinha R, Dungy D, Yeon H (2004) Primary total hip arthroplasty with a proximally porous-coated femoral stem. J Bone Joint Surg 86-A:1254–1261

    PubMed  Google Scholar 

  37. Surdam J, Archibeck M, Schultz S, Junick D, White R (2007) A second-generation cementless total hip arthroplasty mean 9-year results. J Arthroplasty 22:204–209

    Article  PubMed  Google Scholar 

Download references

Funding

This study was funded by Smith & Nephew Orthopaedics AG, Baar, Switzerland. The sponsor had no involvement in the writing of the report or in the decision to submit the results for publication.

Conflict of interest

The authors’ institution has received a research grant from Smith & Nephew Orthopaedics AG, Baar, Switzerland. The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Riga Stradins University, Latvian State Hospital of Traumatology and Orthopaedics, Duntes iela 12/22, Riga, Latvia

    Peteris Studers, Danils Belajevs, Vitolds Jurkevics & Peteris Likums

Authors
  1. Peteris Studers
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Danils Belajevs
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Vitolds Jurkevics
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Peteris Likums
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peteris Studers.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Studers, P., Belajevs, D., Jurkevics, V. et al. Ten to fifteen-year clinical and radiographic follow-up with a third-generation cementless stem in a young patient population. International Orthopaedics (SICOT) 40, 465–471 (2016). https://doi.org/10.1007/s00264-015-2846-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-015-2846-z

Keywords

Search

Navigation